Paper #45 - ISHA Annual Scientific Meeting 2016

Arthroscopic Treatment of Acetabular Chondral Defect Using Bst-Cargel

Chanseok Rhee, MD, Halifax, Nova Scotia CANADA
Eyal Amar, MD, Tel Aviv ISRAEL
Ivan Wong, MD, FRCSC, Dip. Sports Medicine, MACM, Halifax CANADA

Dalhousie University, Halifax, Nova Scotia, CANADA

FDA Status Cleared

Summary: Arthroscopic Treatment of Acetabular Chondral Defect Using BST-CarGel in conjunction with microfracture produce improved outcomes both clinically and radiographically without significant adverse events.

Purpose of Study: Acetabular cartilage lesions are a common pathology found in patients undergoing hip arthroscopy and may cause pain and functional limitation. Irrespective of the cause, chondral lesions have nearly no self-repair capabilities, and most likely will progress to generalized degeneration if left untreated. Several strategies have been developed to treat chondral defect with no overwhelming success. Recently, BST-CarGel (Piramal Life Sciences, Bio-Orthopaedic Division) which is a gel-forming biopolymer (Chitosan based) injectable medical device has gained interests as a scaffolding material that can be injected into the site of micro-fracture to stabilize the clot and facilitate the cartilage repair. This study aims to perform a retrospective analysis of prospectively collected data to evaluate the short-term outcome of patients treated arthroscopically with BST-CarGel for acetabular chondral defect.
Description of Methods: Between November 2014 and December 2015, 22 patients (23 hips) underwent hip arthroscopy for correction of femoroacetabular impingement, labral repair and treatment of acetabular chondral defect. Patient evaluations included general assessment with iHOT-33 questionnaire at the time of preoperative consultation, and the postoperative follow-up at 6 months, 1 year and 2 year marks. In addition, preoperative and postoperative plain radiographs and MR arthrogram scans were analyzed for evaluation.
Summary of Results: 22 patients (23 hips) have been evaluated with mean age of 33.34 years at time of the index operation. There were 16 males (17 hips, mean age of 32.00) and 6 female (6 hips, mean age of 37.15). Minimum follow up time was 6 months. The preoperative iHOT-33 score was 46.3 and the score at 6 months postoperative visit was 61.1, and this improvement was statistically significant (p=0.015). MR arthrograms at 1 year postoperatively demonstrated a significant fill of the chondral defects. There were two patients with severe early postoperative pain, but otherwise no significant adverse outcomes have been reported.
Conclusions: Arthroscopic treatment of chondral acetabular defect with BST-CarGel demonstrates statistically significant improvement in iHOT-33 score and encouraging signs of cartilage healing as shown on MR arthrograms without significant adverse outcomes.